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Crohn's Disease Forum » Surgery » Stoma Subforum » Diversion colitis?


09-19-2012, 06:01 AM   #1
Malgrave
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Diversion colitis?

Has anybody with temporary stoma has any experience with the diversion colitis?
My 5-year old son with temporary ileostomy started to bleed (from the anus) 12 months after the installation of the stoma. There is also a LOT of mucus coming out, almost daily. This has been going on almost for a year now. His doctor thought it could be because of diversion colitis, but the problem is that the colonoscopies don't support this. He used to have inflammation also in the small bowel and granulomas in the stomach before the ileostomy and now they are gone, only the large colon is badly inflammated. So could it be after all the ileostomy that causes the problems now?

I have also heard that in case of Crohn's disease it maybe impossible to make a difference with diversion colitis and inflammation caused by the disease itself. So now the big question for the doctors is, should they close the stoma to cure the diversion colitis or is it too risky if it was not diversion colitis after all...
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*Son (9 years) with severe Crohn's diagnosed at the age of 26 months, currently UC or Crohn's colitis
*Current mediacation: IVIG, Humira, Azathpriorine, Eusaprim
(Tested but failed: Modulen IBD, Neocate advance, Budenofalk, Remicade, Azathpriorine, MTX, Jerusalem cocktail, cycklosporine, pentasa,...)
09-19-2012, 09:02 AM   #2
Aussie
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Hi Malgrave, the fact that the small bowel and gastric Crohns has settled, likely due to the Humira, then the worsening inflammation in the colon could well be diversion colitis, best way to see would be to reverse the stoma. Wouldn't expect Humira to help in diversion colitis, and it sounds like your doctor is going to stop the Humira and change it to Remicade, which would be a shame to stop something that might well be doing really well for the Crohns disease.

I guess at the end of the day, your son either has diversion colitis, so a reversal would be a good idea. Or he has biologic refractory colitis despite faecal diversion, which would get worse on reversal and would likely need a colectomy.

Probably the worst thing to do is just continue as is because he is getting worse.

Tough situation, hope it all ends well!
09-19-2012, 09:41 AM   #3
Malgrave
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Thanks a lot Aussie! In fact he has been on Remicade which was stopped because his inflammation levels are so high and he just keeps bleeding. Humira is proposed to be the next. But all the same, maybe Remicade has helped but now we really don't know!
09-19-2012, 01:08 PM   #4
Terriernut
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Sorry to hear your little one is having such a hard time. (and you!)

I've not personally experienced this, but from the stoma nurse I heard about it. They dont think it's diversion colitis? But it presents as such?

Is it throughout the colon, or just isolated to certain sections? (besides the rectum)

I hope they get him on the mend as soon as possible.
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